Disclaimer

This project was funded by the Agency for Healthcare Research and Quality (AHRQ), U.S. Department of Health and Human Services. The opinions expressed in this document are those of the authors and do not reflect the official position of AHRQ or the U.S. Department of Health and Human Services.

None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.

Copyright

This document is in the public domain and may be used and reprinted without permission except those copyrighted materials that are clearly noted in the document. Further reproduction of those copyrighted materials is prohibited without the specific permission of copyright holders.

Preface

This project was funded as an Accelerating Change and Transformation in Organizations and Networks (ACTION) task order contract. ACTION is a 5-year implementation model of field-based research that fosters public-private collaboration in rapid-cycle, applied studies. ACTION promotes innovation in health care delivery by accelerating the development, implementation, diffusion, and uptake of demand-driven and evidence-based products, tools, strategies, and findings. ACTION also develops and diffuses scientific evidence about what does and does not work to improve health care delivery systems. It provides an impressive cadre of delivery-affiliated researchers and sites with a means of testing the application and uptake of research knowledge. With a goal of turning research into practice, ACTION links many of the Nation's largest health care systems with its top health services researchers. For more information about this initiative, go to http://www.ahrq.gov/research/findings/factsheets/translating/action/index.html.

Acknowledgments

Agency for Healthcare Research and Quality (AHRQ) funding supported personnel at the Centers for American Indian and Alaska Native Health, at the Colorado School of Public Health, and at Denver Health to implement the project. However, this project would not have been possible without the collaboration and contributions of Indian Health Service (IHS) and Tribal health personnel, members of the project’s Steering Committee who represented other Native organizations, and our project consultants. We would like to acknowledge the contributions of IHS personnel from the Pharmacy Program (Principal Pharmacy Consultant, Capt. Chris Watson, R.Ph., M.P.H., CDR), the Division of Diabetes Treatment and Prevention (Acting Directors Lorraine Valdez, R.N., B.S.M., M.P.A. and Ann Bullock, M.D.), the Office of Information Technology, and the Office of Public Health Support, as well as CDR Sherri Yoder, Pharm.D., BCPS, the AHRQ-IHS Liaison. We would also like to acknowledge Sue Ehrhart, from Eyak Technology, LLC, for her assistance with extracting and understanding data from the IHS National Data Warehouse. Invaluable expertise and advice were provided by our project consultants, including Dr. Charlton Wilson; Dr. Rong Yi from Milliman; and Peggy Sheets, Jim Lamont, and Phil Barry, who are financial consultants from the EighteenNineteen Group, Inc. Lastly, this project would not have been feasible without the critical guidance and advice provided by representatives of each of the 14 IHS Service Units who collaborated with us on the project.